title: The Riks-Stroke story: building a sustainable national register for quality assessment of stroke care.
abstract: BACKGROUND
  Riks-Stroke, the Swedish Stroke Register, is the world's longest-running national stroke quality register (established in 1994) and includes all 76 hospitals in Sweden admitting acute stroke patients. The development and maintenance of this sustainable national register is described.
  
  
  METHODS
  Riks-Stroke includes information on the quality of care during the acute phase, rehabilitation and secondary prevention of stroke, as well as data on community support. Riks-Stroke is unique among stroke quality registers in that patients are followed during the first year after stroke. The data collected describe processes, and medical and patient-reported outcome measurements. The register embraces most of the dimensions of health-care quality (evidence-based, safe, provided in time, distributed fairly and patient oriented).
  
  
  RESULTS
  Annually, approximately 25,000 patients are included. In 2009, approximately 320,000 patients had been accumulated (mean age 76-years). The register is estimated to cover 82% of all stroke patients treated in Swedish hospitals. Among critical issues when building a national stroke quality register, the delicate balance between simplicity and comprehensiveness is emphasised. Future developments include direct transfer of data from digital medical records to Riks-Stroke and comprehensive strategies to use the information collected to rapidly implement new evidence-based techniques and to eliminate outdated methods in stroke care.
  
  
  CONCLUSIONS
  It is possible to establish a sustainable quality register for stroke at the national level covering all hospitals admitting acute stroke patients. Riks-Stroke is fulfilling its main goals to support continuous quality improvement of Swedish stroke services and serve as an instrument for following up national stroke guidelines.
authors.affiliation: Riks-Stroke, Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. kjell.asplund@branneriet.se
authors.forename: Kjell
authors.initials: K
authors.lastname: Asplund
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hulter Åsberg
authors.forename: Peter
authors.initials: P
authors.lastname: Appelros
authors.forename: Daniela
authors.initials: D
authors.lastname: Bjarne
authors.forename: Marie
authors.initials: M
authors.lastname: Eriksson
authors.forename: Asa
authors.initials: A
authors.lastname: Johansson
authors.forename: Fredrik
authors.initials: F
authors.lastname: Jonsson
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
authors.forename: Birgitta
authors.initials: B
authors.lastname: Stegmayr
authors.forename: Andreas
authors.initials: A
authors.lastname: Terént
authors.forename: Sari
authors.initials: S
authors.lastname: Wallin
authors.forename: Per-Olov
authors.initials: PO
authors.lastname: Wester
mesh_terms: D006801:Humans; D009462:Neurology / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D012042:Registries / Q000592:standards / Q000706:statistics & numerical data; D020521:Stroke / Q000628:therapy*; D013548:Sweden